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Organization

ESSENTIAL ELEMENTS COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRENDA WHITE LCPC (OWNER)
(312) 971-6653
Entity
Organization

Contact information

Practice address
402 W BOUGHTON RD, SUITE G, BOLINGBROOK, IL 60440-1872
(312) 971-6653
(888) 559-6640
Mailing address
402 W BOUGHTON RD, SUITE G, BOLINGBROOK, IL 60440-1872
(312) 971-6653
(888) 559-6640

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
180.009144
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180.009144
IDFPR
IL
Enumeration date
10/01/2015
Last updated
10/01/2015
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